Bulbar Palsy

Question 1

What is it

Answer 1

• weakness or paralysis of the muscles innervated by the motor nuclei of the lower brainstem
• affects the muscles of the face, tongue, larynx, and pharynx
  CN IX, X, XI, XII

Question 2

etiology

Answer 2

the result of tumors, vascular or degenerative disease of lower cranial nerve motor nuclei (ALS)

Question 3

is Bulbar Palsy UMNL or LMNL

Answer 3

LMNL

Question 4

examination

Answer 4

• glossopharyngeal and valor paralysis
• changes in voice quality
• bilateral involvement: severe airway restriction with dyspnea, difficulty coughing
• possible complication: aspiration pneumonia

Question 5

pseudobulbar palsy

Answer 5

bilateral dysfunction of corticobulbar innervation of brainstem nuclei
- a central or UMN lesion analogous to corticospinal lesions disruption function of anterior horn cells
- similar symptoms

Question 6

What to examine for pseudo bulbar palsy

Answer 6

increased jaw jerk, and snout reflex (tapping on lips produces pouting of lips)

Question 7

physical therapy goals

Answer 7

• suctioning, oral care
• maintenance of respiratory function, open airway
• elevate HOB
• dietary changes: soft foot, liquids

Question 8

prognosis

Answer 8

poor: 3 years